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A Natural Treatment For Hot Flashes
(05/04/2004) by Unknown
Reprinted from Vol. XVII, No. 8 (c)1999 DKT International, Chapel Hill, North Carolina. All Rights Reserved. January, 1999
"There I was, in the middle of an important presentation that I had worked
on for three months, standing in front of maybe 200 people when I felt it
coming," said Laurie, a 49-year-old insurance executive. "I tried to act
like nothing was happening, but I felt my whole face turning bright red and
the perspiration running down my cheeks. I was so embarrassed. I didn't
know what to do."
Like Laurie, millions of women who are getting close to menopause have
experienced the all-too-uncomfortable invasion of hot flashes. In fact,
they are the most common and among the most unpleasant of the symptoms that
accompany a woman's change of life.
In her best-selling book, The Silent Passage, Gail Sheehy notes that about
half of all women who have hot flashes begin experiencing them while still
menstruating, starting as early as age 40. Sheehy wrote, "Studies show that
most women have hot flashes for two years. One-quarter of women have them
for five years. And 10 percent have them for the rest of their lives."
Hot flashes can strike at any time, at an important board meeting, on a
date, or even during sleep when a woman can awaken drenched in sweat. They
also can have a very negative impact on her sex life.
For women who experience frequent and/or severe hot flashes, the fear that
they can strike at anytime may deter her from making love altogether. A
strike of hot flashes during intercourse may cause such discomfort that she
withdraws, leaving her partner bewildered. Hot flashes also may be
accompanied by unpleasant tingling sensations in hands and feet, headaches,
nervousness, and insomnia - none of which is conducive to relaxed or happy
lovemaking.
Many women experience both hot flashes and vaginal dryness (which is easily
treated), compounding their sexual difficulties. It is important that
partners discuss these changes and that he understand that she is not
rejecting him sexually, but she may need a bit of time to recover from her
distress.
The discomfort of hot flashes is a major reason that many women turn to
hormone replacement therapy (HRT). That works for many, but some women are
concerned about side effects of HRT. Though HRT has the beneficial effect
of decreasing the risk of heart attacks, it increases the risk of breast
and endometrial cancers.
Millions of women wonder if there is a better solution.
"Yes," said Robert R. Freedman, PhD, professor of psychiatry and behavioral
neurosciences and obstetrics and gynecology at the Wayne State University
School of Medicine in Detroit. "It's yoga breathing, slow abdominal
breathing." With the proper use of breathing techniques, Freedman said
that his research has proved that most women can decrease the frequency of
hot flashes by about 50 percent.
The Discovery
Freedman came upon his discovery by accident in the mid-1980's while
conducting research on a disorder called Raynaud's disease that is
characterized by cold hands. Through biofeedback, he was able to help
relieve the discomfort of the cold hands.
As it happened, one of his graduate students mentioned that his mother was
suffering from hot flashes but was unable to undertake hormone replacement
because she had been diagnosed with breast cancer.
"He had read my work showing that I could take cold women and make them
warm, so he wanted to know if I could take warm women and make them cold,"
said Freedman. "I told him I didn't have a clue, but I would try. And
that's how this work began."
Testing different disciplines, including biofeedback and relaxation
techniques, Freedman discovered that "the whole effect was accomplished by
the breathing alone, so now that is what we teach."
Most people breathe between 15 and 17 times per minute. In the yoga
breathing technique taught by Freedman, women are trained to cut this in
half, breathing only 8 or 9 times a minute.
And not only do the women breathe more slowly, they also learn to breathe
more deeply. Taught to expand their bellies and decrease chest breathing,
their breathing is no longer shallow but instead comprises full breaths.
The yoga term is "belly breathing."
Freedman believes the best way for women to learn this breathing technique
is by enrolling in a yoga class. "It is very important to have a human
trainer to observe you and give you feedback on what you are doing right
and wrong," he said. "You do better training with a person as opposed to a
book or a video."
Almost all yoga classes teach breathing, the core of this ancient
discipline. Once a woman has learned belly breathing, she should practice
it twice a day for 15 minutes at a time. She also should use yoga breathing
in situations where she is likely to have a hot flash, such as warm spaces.
Sometimes a woman can feel a flash coming and the breathing will abort it
or lessen its severity.
Will other people notice what she is doing? "I think you can do it
unobtrusively, but some people are self-conscious," he said. "Ideally, I
would like to develop some kind of conditioning procedure that would be
automatic and unobtrusive, but I haven't come up with the idea yet."
Freedman has taught yoga breathing techniques to hundreds of women over the
past 10 years, and papers documenting his controlled studies have appeared
in publications including the American Journal of Obstetrics and
Gynecology.
Menopausal Changes
"Menopause" actually refers to a point in time, the moment of a woman's
last menstrual period. This point can only be identified after about a year
of not menstruating. "Perimenopause" is the period leading up to menopause
and "postmenopause" is the time after.
For most women, hot flashes begin in the perimenopausal period. Some women
never experience hot flashes while others have them for differing
durations. Some have brief, mild flushing, and others have as many as 24 or
more severe hot flashes daily.
Hormonal changes, including fluctuating levels of estrogen, cause hot
flashes, although the exact mechanism is still unclear. Heart, blood flow
and perspiration rates increase, and the skin becomes warm and reddens. In
most cases, hot flashes disappear after a few minutes, but they can last
for up to an hour. When flashes occur at night, they can cause serious loss
of sleep.
Other Possible Remedies
Besides HRT, which often solves the problem, other approaches that have
been tried include the following:
- Clonidine: An antihypertensive for women who do not want to use hormones.
Side effects include fatigue, constipation, and dry mouth.
- Diet: Eliminating caffeine, alcohol, spicy and very hot foods may
decrease the severity and frequency of hot flashes; a diet rich in soy may
also be helpful.
- Exercise: Regular aerobic exercise may reduce problems with hot flashes.
- Air Conditioning: Staying in a cool environment, especially in the
summer, can help many women.
- Vitamins: Some studies show that supplements of herbs dong quai and
ginseng and of vitamins E and B-6 may be helpful.
Freedman's Views
Freedman is generally in favor of HRT although he points out that
controversy surrounds the potential long-term effects. However, the women
he has worked with over the years are not on HRT.
"About half the women who come to me have had breast cancer [and are not
able to use HRT] and the other half are women who refuse to take any
medication at all or have tried HRT and went off it because they didn't
like the side effects, like weight gain, bloating, or bleeding," he said.
Freedman, for one, is skeptical about the other alternatives. "I would not
make a big deal about avoiding caffeine or alcohol," he said. He thinks
studies on soy products are unconvincing, believes exercise can make hot
flashes worse, and cautions that vitamin and herbal products can be
dangerous due to poor regulation.
"You don't know what you're getting," he said, noting that a woman with
breast cancer could have problems if she uses too many soy products, which
are high in genistein, an estrogen-like substance.
But he does agree that staying cool is effective. "One thing that
definitely increases hot flashes is heat," he said. "So if you have a
couple of hundred dollars, go out and buy an air conditioner for your
bedroom. That's the best advice I can give."
Besides breathing techniques, which he is convinced work well - though he
is not yet able to fully explain why.
"Women who've been trained to use this technique as soon as they feel a
flush coming on are often able to abort the flash," said Freedman. "Or at
least reduce its severity." This article appears in the following topics:
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